Nd: YAG Laser Sapphire Tip in Operative Hysteroscopy — A Preliminary Report

The subject of my report is contact laser technique in operative hysteroscopy. It is my opinion that this newly developed laser technique will play a very important role in future operative hysteroscopy. To make my point clear I would like at the beginning to recall the known indications for operative hysteroscopy. They are: septa, synechia, polyps, myopas and, as fifth indication, bleeding, in my opinion, impossible to treat by means of conventional methods. At present we have following methods for intrauterine surgery: for conventional methods we can use sharp cutting instruments often combined with electrocautery. The instruments are: known in urology resecto-scopes and electrosurgical cutting loop. To exclude the danger of insufflation of CO₂ in blood vessels we have to use during operative hysteroscopy liquid distension medium, for example, Hyskon or 5% glucose with continuous or interrupted flow. All hysteroscopists know exactly how uncomfortable is this technique. Because of danger of bleeding the conventional operative hysteroscopy requires very often vasoconstrictors; for proper coagulation we need the electro-surgical unit with a power of 50 watts. A possibility of transcervical intrauterine operation eliminates in many cases the need for an extended abdominal operation.